Individual provider Active NPI

Courtney Ballard, LPC-MH

  • Mental Health Counselor
  • Yankton, SD
National Provider Identifier
1548868938
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
30740 Issued in SD
Practice address
904 W 23Rd St Ste 101
Yankton, SD 57078-1206
Phone
(605) 665-0841
Fax
(605) 665-0096
NPI assigned
Oct 16, 2020
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 30740 SD Primary

Addresses

Primary practice location

904 W 23Rd St Ste 101
Yankton, SD 57078-1206

Mailing address

614 Broadway Ave
Yankton, SD 57078-3516
Phone (605) 665-0841

Other practice location 1

116 Market St Ste 101
Vermillion, SD 57069-3040
Phone (605) 665-0841

Other names 1

  • Courtney Marshall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105000882 SD Practitioner - Mental Health Counselor 2163873944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Wellness CollectiveGroup PAC ID 1951722834, 9 clinicians

Practice addresses (Care Compare)

2333 W 57TH St
Suite 103
Sioux Falls, SD 57108-5054
Phone (605) 271-5640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30740SDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Collective LLC Mental Health CurrentSince Sep 25, 2024 Accepting new patients
Heartland Psychological Services Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Heartland Psychological Services Mental Health PastSince Oct 19, 2020 Accepting new patients

Locations

2333 W 57th St
Ste 103
Sioux Falls, SD 57108
Phone (605) 271-5640

116 Market St
Vermillion, SD 57069
Phone (605) 665-0841

116 Market St
Ste 101
Vermillion, SD 57069
Phone (605) 665-0841

614 Broadway Ave
Yankton, SD 57078
Phone (605) 661-0841

904 W 23rd St
Ste 101
Yankton, SD 57078
Phone (605) 665-0841

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1548868938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 BROADWAY AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783516",
            "telephone_number": "605-665-0841",
            "fax_number": "605-665-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W 23RD ST STE 101",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570781206",
            "telephone_number": "605-665-0841",
            "fax_number": "605-665-0096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Market St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Vermillion",
            "state": "SD",
            "postal_code": "570693040",
            "country_code": "US",
            "telephone_number": "605-665-0841",
            "fax_number": "605-665-0096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "COURTNEY",
        "credential": "LPC-MH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "30740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "MARSHALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.